(Answers to Case studies and one nursing care plan )
Chapter 21: Nursing Management of Labor and Birth at Risk
1. Laura is a 26-year-old G2P1 who had a caesarean delivery for fetal distress with her first pregnancy. Laura is now struggling with deciding between a repeat caesarean delivery or attempting a VBAC. (Learning Objective 9)
A. In order to ensure that Laura has the facts to assist her in her decision, explain the risks of a repeat caesarean delivery.
B. Laura can’t understand why more women don’t want to try a VBAC delivery. Discuss the possible reasons for this.
C. Describe the management of care for a woman attempting a VBAC delivery.
2. Carol, age 17, is pregnant with her first child. Her menstrual dates are accurate and her date of conception is limited to one possible day. Her physician gives her an EDC of March 28th. Carol has gone past her due date and refuses to have her labor induced. Carol states, “My grandmother says that the baby will come when it is good and ready.” It is now April 14th and Carol is at 42 3/7 weeks’ gestation. She calls the office and reports that she is having a significant lower backache and she just passed “a glob of bloody mucus” from her vagina. (Learning Objective 5)
A. Discuss the risks a prolonged pregnancy places on Carol.
B. What risks are there for Carol’s unborn baby?
C. Describe the nursing care required for women in labor with a prolonged pregnancy.
Chapter 22: Nursing Management of the Postpartum Woman at Risk
1. Amy calls the office 3 days after delivering a healthy baby girl and tells you she is passing small clots and feels like her bleeding is heavier than it should be. You advise Amy to come into the clinic to be checked. (Learning Objectives 1, 2, 3, and 6)
What are the “four T’s” that need to be assessed in a possible case of postpartum hemorrhage?
Amy also tearfully tells you that she is experiencing anxiety and feelings of being overwhelmed. What is she experiencing, and what education are you going to provide?
2. Alyssa, age 26, had a cesarean delivery 7 days ago and is breast-feeding her baby. She calls the office today and reports that she has a temperature of 102. (Learning Objective 5)
Given the limited information you have, describe the four most likely types of infection Alyssa may have contracted.
What additional questions do you want to ask her to try to ascertain the cause of her fever?
3. Describe the care required to treat each of these infections.
Chapter 24: Nursing Management of the Newborn at Risk: Acquired and Congenital Newborn Conditions
1. On the evening shift in the special care nursery, you are paged to delivery room 5. When you arrive, the labor nurse says the baby has been stuck in the birth canal for a while, and the fetal heart tones are down. They use the vacuum suction to assist delivery. The doctor gets the baby out and places the infant on the radiant warmer. You are the resuscitating nurse for the infant, and you observe the following: the infant is limp, pale, gasping, has poor tone, and the heart rate is 101. (Learning Objective 1)
What are your first actions to aid in this infant’s recovery?
What Apgar score would you assign at 1 minute with these results? Explain the score for each category.
2. Tammi is an 18-year-old single mother who delivered a full-term infant 3 days ago. The father is not involved, and Tammi’s aunt is her support person. The infant is very fussy in the nursery, with mild tremors noted. Tammi is having a hard time feeding her baby, the baby spits up a lot and he does not console easily. The physician has been called to assess the infant. (Learning Objective 7)
What is the probable cause of the infant’s symptoms, and what questions do you need to ask the mother?
What is the acronym of the tool used in assessing the infant’s condition, and what are the top three substances used that can cause this condition?
Name what measures are used to test for this condition and on whom you perform the test.
3. Mandy just gave birth vaginally to her first child. Mandy and James had attended prenatal classes and had a natural childbirth. They were totally unprepared to see that baby “Rose” has a severe left-sided unilateral cleft lip and cleft palate. James is having a hard time with this and just keeps staring at the baby. Mandy begins to cry and states “I thought I was going to breast-feed my baby and now it’s impossible.” (Learning Objectives 12, 14, and 15)
A. Discuss the implications for bottle feeding and breast-feeding a baby with a unilateral cleft lip. Is it possible for Mandy to breast-feed Rose?
B. What is involved in the surgical correction of the defect? When can she eventually have a “normal” mouth and facial features?
C. What other problems may develop for Rose since she has this type of defect?
D. How can you assist the family bond with Rose?
NURSING CARE PLANS (NCP)
1 from high risk OB (ch 21-24).
NCP are to be written in using the included Rubric. Do NOT use a grid format… use an “essay” style format or bullet point using the included Grading Rubric.
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You must proofread your paper. But do not strictly rely on your computer’s spell-checker and grammar-checker; failure to do so indicates a lack of effort on your part and you can expect your grade to suffer accordingly. Papers with numerous misspelled words and grammatical mistakes will be penalized. Read over your paper – in silence and then aloud – before handing it in and make corrections as necessary. Often it is advantageous to have a friend proofread your paper for obvious errors. Handwritten corrections are preferable to uncorrected mistakes.
Use a standard 10 to 12 point (10 to 12 characters per inch) typeface. Smaller or compressed type and papers with small margins or single-spacing are hard to read. It is better to let your essay run over the recommended number of pages than to try to compress it into fewer pages.
Likewise, large type, large margins, large indentations, triple-spacing, increased leading (space between lines), increased kerning (space between letters), and any other such attempts at “padding” to increase the length of a paper are unacceptable, wasteful of trees, and will not fool your professor.
The paper must be neatly formatted, double-spaced with a one-inch margin on the top, bottom, and sides of each page. When submitting hard copy, be sure to use white paper and print out using dark ink. If it is hard to read your essay, it will also be hard to follow your argument.
ADDITIONAL INSTRUCTIONS FOR THE CLASS
Discussion Questions (DQ)
Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
I encourage you to incorporate the readings from the week (as applicable) into your responses.
Weekly Participation
Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.
APA Format and Writing Quality
Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
I highly recommend using the APA Publication Manual, 6th edition.
Use of Direct Quotes
I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
It is best to paraphrase content and cite your source.
LopesWrite Policy
For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.
Late Policy
The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
I do not accept assignments that are two or more weeks late unless we have worked out an extension.
As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.
Communication
Communication is so very important. There are multiple ways to communicate with me:
Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.
